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Serotonin syndrome presenting with migrainelike stroke
1Seton Hall University, South Orange, NJ, USA.
Headache
|November 5, 1997
Summary
Serotonin syndrome, a drug interaction enhancing central nervous system serotonin, can cause neurological issues. A rare case links this syndrome to ischemic stroke, suggesting a potential shared pathogenesis with migraine-related ischemia.
Area of Science:
- Neuroscience
- Pharmacology
- Neurology
Background:
- Serotonin syndrome arises from drug interactions increasing central nervous system serotonergic activity.
- Neurological symptoms are typically transient, with infrequent fatalities reported.
Observation:
- A 30-year-old woman experienced ischemic infarction in the right temporoparietal and cerebellar hemispheres.
- This occurred 48 hours after high-dose clomipramine administration, following abrupt discontinuation of high-dose fluoxetine.
Findings:
- Both clomipramine and fluoxetine are known to enhance serotonergic tone.
- The infarction pattern was atypical, not conforming to major arterial territories, resembling spreading oligemia/ischemia seen in migraines.
Implications:
- This case suggests a potential link between serotonin syndrome and ischemic stroke.
- A similar underlying mechanism, akin to that in migraine, may contribute to stroke development in serotonin syndrome.